The effect of the pooling method on the live birth rate in poor ovarian responders according to the Bologna criteria.

Serdar Çelik,Dilek Cengiz Çelik,Mustafa Bahçeci,Niyazi Emre Turgut,Remzi Abalı,Erbil Yağmur,Kübra Boynukalın,Sevim Purisa

doi:10.4274/tjod.62447

Serdar Çelik, Dilek Cengiz Çelik + Show 6 more

Open Access

https://doi.org/10.4274/tjod.62447

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Abstract

Objective:Pooling is an alternative method to achieve in vitro fertilization outcomes. This study was to investigate the effect of pooling method on pregnancy outcomes in poor responder patients according to Bologna criteria.Materials and Methods:Two hundred-fifty five poor responder patients were enrolled in this study. Pooling embryo transfer (ET) group had 110 and fresh ET group had 145 patients.Results:Although, age was similar between both treatment groups (p=0.31), antral follicle count (p<0.001), total number of retrieved oocyte (p<0.001), total metaphase II oocyte count (p<0.001), number of stimulation cycles (p<0.001), were significantly different between the groups. The day of ET were similiar between two groups (p=0.72) but the number of ET procedure was significantly higher in pooling ET group compared to fresh ET (p<0.001). Positive pregnancy test [35/110 (32%) vs 53/145 (37%)] (p=0.43) and clinical pregnacy rates [31/110 (28%) vs 49/145 (34%)] (p=0.33) were similar between groups, whereas, implantation [31/191 (16%) vs 49/198 (25%)] (p=0.03) and live birth rates [15/110 (14%) vs 36/145 (25%)] (p=0.04) were significantly higher in fresh ET group. Despite that, abortion rates were significantly higher in pooling ET group [16/31 (52%) vs 13/49 (27%)] (p=0.04). Binary logistic regression analyese has revealed no effect of variables on live birth rates.Conclusion:Even though, pooling strategy seems to have a slight positive effect on pregnancy outcomes, there is no benefical effect on live birth rates. Furthermore, this strategy is increasing the abortion rates in parallel with clinical pregnancy rates.

Highlights

There is ongoing debate about the management of poor responder women in in vitro fertilisation (IVF) centres
frozen/thawed embryo transfer (FET) has become an alternative method to fresh embryo transfer (ET) in normoresponder women, but there is no consensus about the use of FET in poor responder patients
The age was similar in both treatment arms (p=0.31), but the antral follicle count, total number of retrieved oocytes (p=0.001), total number of metaphase II (MII) oocytes (p=0.001), total gonadotropin dose (p=0.001), number of stimulation cycles (p=0.001), and cost of treatment (p=0.001) were significantly different

Summary

Introduction

There is ongoing debate about the management of poor responder women in in vitro fertilisation (IVF) centres They receive an increased gonadotropin dose compared with normoresponders, fewer oocytes are eligible for the procedure, and the pregnancy outcomes are lower[1,2,3]. Physicians have focussed on other methods of increasing pregnancy rates in poor responder women. Several treatment options, such as oestrogen use in the luteal phase[4], adding a recombinant luteinizing hormone preparation during stimulation[5], and pre-treatment with growth hormone[6] and androgen[1] have been investigated. Sites et al[7] reported significantly lower live birth rates with slow freezing compared with vitrification (25% vs 71%) and fresh embryo transfer (ET) (ET; 25% vs 70%)(8). The aim of this study was to investigate the effect of embryo collection on the pregnancy, clinical pregnancy and live birth rates in poor responder women, as defined according to the Bologna criteria[14]

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